MEDICARE: SARAH ELIZABETH ARNDT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-17-28623	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-17-28623	OTHER	GA	BACB

General Provider Information

NPI Number	:	1457869075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ELIZABETH ARNDT

Provider Business Mailing Address
First Line	:	1215 HIGHTOWER TRL
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30350-6244
Country	:	US
Telephone Number	:	866-750-5554
Fax Number	:

Provider Business Practice Location Address
First Line	:	1215 HIGHTOWER TRL
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30350-6244
Country	:	US
Telephone Number	:	866-750-5554
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2018
Last Update Date	:	01/17/2018

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